2-Attachment B-Bidders Cert.pdf
PDF 1 MB Posted
- Attached to
- Haag-Streit BQ 900 LED Slit Lamp with Imaging
- Solicitation number
- PROJ-25-160A
- Issued by
- Volusia County, Florida
About this file
This is a Bidders Certification document for Halifax Health Medical Center related to Invitation to Bid (ITB) #PROJ-25-002 in Florida. The document serves as a certification form that bidders must complete and submit as part of their bid package for the procurement of a Haag-Streit BQ 900 LED Slit Lamp with Imaging. The certification requires bidders to confirm receipt of complete bid papers and commit to adhering to all contained information and requirements.
Bidders must certify compliance with multiple regulatory and ethical standards, including confirmation that they have not engaged in collusion or unethical practices, that they comply with all federal, state, and local laws regarding equal opportunity employment, that they maintain a written sexual harassment policy in accordance with applicable requirements, and that they will abide by all federal, state, and local codes and regulations. Additionally, bidders must provide a tax certification affirming they are not barred from contracting with any unit of local government in Florida due to tax delinquency with the Florida Department of Revenue, unless they are actively contesting their tax liability through established procedures. The certification document requires signature by an authorized corporate or company official and must be notarized, with all sections to be completed clearly with company name, address, official title, telephone, and email information.
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Text version
ATTACHMENT B
HALIFAX HEALTH MEDICAL CENTER
BIDDERS CERTIFICATION
ITB # PROJ-25-002
I/We hereby certify that:
A. A complete set of bid papers, as intended, has been received, and I/We will abide by the contents and/or information received and/or contained herein.
B. I/We have not entered into any collusion or other unethical practices with any person, firm, or employee of the District which would in any way be construed as unethical practice.
C. I/We comply with all current federal, state and local laws, statutes, rules, and regulations referencing equal opportunity employment practices.
D. I/We have adopted a written sexual harassment policy which is in accordance with the requirements of federal, state and local laws, regulations and policies.
E. I/We will abide by all other federal, state and local codes, rules, regulations, ordinances and statutes.
COMPANY NAME
ADDRESS
DISTRICT/STATE/ZIP CODE
NAME OF CORPORATE/COMPANY OFFICIAL
(PLEASE TYPE OR PRINT CLEARLY)
TITLE
AUTHORIZED OFFICIAL SIGNATURE
DATE
TELEPHONE ( )
HALIFAX HEALTH MEDICAL CENTER
STATE OF FLORIDA
ITB # PROJ-25-002
COUNTY OF
BIDDER’S TAX CERTIFICATION
(BIDDER’S EXECUTING OFFICER), being first duly sworn on oath, deposes and states that all statements made herein are made on behalf of the Bidder, that this respondent is authorized to make them and that the statements contained herein are true and correct. Bidder deposes, states and certifies that Bidder is not barred from contracting with any unit of local government in the State of Florida as result of a delinquency in payment of any tax administered by the Florida Department of Revenue unless Bidder is contesting, in accordance with the procedures established by the appropriate statute, its liability for the tax or the amount of the tax.
DATED this day of , 2024.
By (Bidder’s Executing Officer)
(Name of Bidder’s Executing Officer)
(Title)
ATTEST/WITNESS:
By
Title
Subscribed and sworn to before me this day of , 2024.
Notary Public
(SEAL)
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